Small-bore Catheter Versus Conventional Chest Tube Drainage For Pneumothorax

Objective:The aim of this study was to compare the effectiveness of drainage via a single-lumen (5F catheter equivalent to16G catheter) central venous catheter (CVC) to a conventional (14-20F catheter) chest tube (CT) for the management of pneumothoraces, including primary spontaneous pneumothorax (PSP), secondary spontaneous pneumothorax (SSP) associated with chronic obstructive pulmonary disease, and iatrogenic pneumothoraces and traumatic pneumothoraces.Methods.:All consecutive patients admitted to the department of thoracic surgery, Number4People’s Hospital of Jinan City, for pneumothorax were retrospectively screened over an8-year period. Patients were preferentially treated using CT from2004to2007(control group) and using CVC from2008to2011(observation group). Drainage failure was defined as the need for a second drainage procedure or for surgery.Results:Of212patients included,117(55%) had PSP,28(13%) had SSP associated with chronic obstructive pulmonary disease,19(9%) had traumatic pneumothorax, and48(23%) had iatrogenic pneumothorax. The failure rate was23%in PSP,36%in SSP,16%in traumatic pneumothorax, and only2%in iatrogenic pneumothorax. After adjustment, iatrogenic pneumothorax was the only factor that had an influence on drainage failure. The failure rate was similar between the112patients treated using CVC and the100patients treated using CT (18%vs21%, P=.60). However, the durations of drainage (3.3±1.9vs4.6±2.6days, P<.01) and of hospital stay were significantly shorter in patients treated using CVC as compared with CT.Conclusion:Our findings suggest that drainage via a catheter or via a CT is similarly effective in the management of pneumothorax. We recommend considering drainage via a small-bore catheter as a first-line treatment in patients with pneumothorax, whatever its cause.